Category: Mental Health

Family Therapy

Family Therapy, Mental Health, Therapies

Family therapy is a type of psychological counseling (psychotherapy) that can help family members improve communication and resolve conflicts.

Family therapy is usually provided by a psychologist, clinical social worker or licensed therapist. These therapists have graduate or postgraduate degrees and may be credentialed by the American Association for Marriage and Family Therapy (AAMFT).

Family therapy is often short term. It may include all family members or just those able or willing to participate. Your specific treatment plan will depend on your family’s situation. Family therapy sessions can teach you skills to deepen family connections and get through stressful times, even after you’re done going to therapy sessions.

Why it’s done

Family therapy can help you improve troubled relationships with your partner, children or other family members. You may address specific issues such as marital or financial problems, conflict between parents and children, or the impact of substance abuse or a mental illness on the entire family.

Your family may pursue family therapy along with other types of mental health treatment, especially if one of you has a mental illness or addiction that also requires additional therapy or rehabilitation treatment. For example:

• Family therapy can help family members cope if a relative has a serious mental illness such as schizophrenia — but the person who has schizophrenia should continue with his or her individualized treatment plan, which may include medications, one-on-one therapy or other treatment.

• In the case of addiction, the family can attend family therapy while the person who has an addiction participates in residential treatment. Sometimes the family may participate in family therapy even if the person with an addiction hasn’t sought out his or her own treatment.

Family therapy can be useful in any family situation that causes stress, grief, anger or conflict. It can help you and your family members understand one another better and learn coping skills to bring you closer together.

How you prepare

You can ask your primary care doctor for a referral to a therapist. Family members or friends may give recommendations based on their experiences. You also can ask your employee assistance program, clergy, or state or local mental health agencies for suggestions for therapists.

Before scheduling sessions with a therapist, consider whether the therapist would be a good fit for your family. Here are some factors to consider and questions to ask:

• Education and experience. What is your educational and training background? Are you licensed by the state? Are you accredited by the AAMFT or other professional organizations? Do you have specialty training in family psychotherapy? What is your experience with my family’s type of problem?

• Location and availability. Where is your office? What are your office hours? Are you available in case of emergency?

• Length and number of sessions. How long is each session? How often are sessions scheduled? How many sessions should I expect to have?

• Fees and insurance. How much do you charge for each session? Are your services covered by my health insurance plan? Will I need to pay the full fee upfront? What is your policy on canceled sessions?

What you can expect

Family therapy typically brings several family members together for therapy sessions. However, a family member may also see a family therapist individually.

Sessions typically take about 50 minutes to an hour. Family therapy is often short term — generally about 12 sessions. However, how often you meet and the number of sessions you’ll need will depend on your family’s particular situation and the therapist’s recommendation.

During family therapy, you can:

• Examine your family’s ability to solve problems and express thoughts and emotions in a productive manner

• Explore family roles, rules and behavior patterns to identify issues that contribute to conflict — and ways to work through these issues

• Identify your family’s strengths, such as caring for one another, and weaknesses, such as difficulty confiding in one another

Example: Depression

Say that your adult son has depression. Your family doesn’t understand his depression or how best to offer support. Although you’re worried about your son’s well-being, conversations with your son or other family members erupt into arguments and you feel frustrated and angry. Communication diminishes, decisions go unmade, family members avoid each other and the rift grows wider.

In such a situation, family therapy can help you:

• Pinpoint your specific challenges and how your family is handling them

• Learn new ways to interact and overcome unhealthy patterns of relating to each other

• Set individual and family goals and work on ways to achieve them

Results

Family therapy doesn’t automatically solve family conflicts or make an unpleasant situation go away. But it can help you and your family members understand one another better, and it can provide skills to cope with challenging situations in a more effective way. It may also help the family achieve a sense of togetherness.

Ancient Egyptian Food: Date Candies

Ancient Egyptian Archaeology, Ancient Food, Ancient World, Coping Strategies

This recipe was found on an ostraca (pottery shard) that dates back to 1600 BC. Here’s is a modernized version:

1 cup of fresh pitted dates
1 teaspoon cinnamon
1/2 teaspoon cardamom seeds
1/2 cup ground walnuts
small amount of liquid honey
1/2 cup finely ground almonds

Put the dates, cardamom, cinnamon, and walnuts in a food processor and run at high speed to make a paste. Take chunks of this paste and form it into walnut sized balls. Brush these with some liquid honey and roll them in the ground almonds to coat them.

Adjustment Disorders: Symptoms

Anxiety, Diagnosis Symptoms, Mental Health

Adjustment disorders are stress-related conditions. You experience more stress than would normally be expected in response to a stressful or unexpected event, and the stress causes significant problems in your relationships, at work or at school.

Work problems, going away to school, an illness, death of a close family member or any number of life changes can cause stress. Most of the time, people adjust to such changes within a few months. But if you have an adjustment disorder, you continue to have emotional or behavioral reactions that can contribute to feeling anxious or depressed.

You don’t have to tough it out on your own, though. Treatment can be brief and it’s likely to help you regain your emotional footing.

Symptoms

Signs and symptoms depend on the type of adjustment disorder and can vary from person to person. You experience more stress than would normally be expected in response to a stressful event, and the stress causes significant problems in your life.

Adjustment disorders affect how you feel and think about yourself and the world and may also affect your actions or behavior. Some examples include:

• Feeling sad, hopeless or not enjoying things you used to enjoy

• Frequent crying

• Worrying or feeling anxious, nervous, jittery or stressed out

• Trouble sleeping

• Lack of appetite

• Difficulty concentrating

• Feeling overwhelmed

• Difficulty functioning in daily activities

• Withdrawing from social supports

• Avoiding important things such as going to work or paying bills

• Suicidal thoughts or behavior

Symptoms of an adjustment disorder start within three months of a stressful event and last no longer than 6 months after the end of the stressful event. However, persistent or chronic adjustment disorders can continue for more than 6 months, especially if the stressor is ongoing, such as unemployment.

Causes

Adjustment disorders are caused by significant changes or stressors in your life. Genetics, your life experiences, and your temperament may increase your likelihood of developing an adjustment disorder.

Risk factors

Some things may make you more likely to have an adjustment disorder.

Stressful events

Stressful life events — both positive and negative — may put you at risk of developing an adjustment disorder. For example:

• Divorce or marital problems

• Relationship or interpersonal problems

• Changes in situation, such as retirement, having a baby or going away to school

• Adverse situations, such as losing a job, loss of a loved one or having financial issues

• Problems in school or at work

• Life-threatening experiences, such as physical assault, combat or natural disaster

• Ongoing stressors, such as having a medical illness or living in a crime-ridden neighborhood

Your life experiences

Life experiences can impact how you cope with stress. For example, your risk of developing an adjustment disorder may be increased if you:

• Experienced significant stress in childhood

• Have other mental health problems

• Have a number of difficult life circumstances happening at the same time

Complications

If adjustment disorders do not resolve, they can eventually lead to more serious mental health problems such as anxiety disorders, depression or substance abuse.

Prevention

There are no guaranteed ways to prevent adjustment disorders. But developing healthy coping skills and learning to be resilient may help you during times of high stress.

If you know that a stressful situation is coming up — such as a move or retirement — call on your inner strength, increase your healthy habits and rally your social supports in advance. Remind yourself that this is usually time-limited and that you can get through it. Also consider checking in with your doctor or mental health professional to review healthy ways to manage your stress.

Sources: The Mayo Clinic, NAMI, NIH, NIMH

Antidepressants and Weight Gain?

Depression, Medications, Mental Health, Side Effects

Weight gain is a possible side effect of nearly all antidepressants. However, each person responds to antidepressants differently. Some people gain weight when taking a certain antidepressant, while others don’t.

Generally speaking, some antidepressants seem more likely to cause weight gain than others. These include:

• Certain tricyclic antidepressants, such as amitriptyline, imipramine (Tofranil) and doxepin

• Certain monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil)

• Paroxetine (Paxil, Pexeva), a selective serotonin reuptake inhibitor (SSRI)

• Mirtazapine (Remeron), which is an atypical antidepressant — medication that doesn’t fit neatly into another antidepressant category

While some people gain weight after starting an antidepressant, the antidepressant isn’t always a direct cause. Many factors can contribute to weight gain during antidepressant therapy. For example:

• Overeating or inactivity as a result of depression can cause weight gain.

• Some people lose weight as part of their depression. In turn, an improved appetite associated with improved mood may result in increased weight.

• Adults generally tend to gain weight as they age, regardless of the medications they take.

If you gain weight after starting an antidepressant, discuss the medication’s benefits and side effects with your doctor. If the benefits outweigh the side effect of weight gain, consider managing your weight by eating healthier and getting more physical activity while enjoying an improved mood due to the medication.

You can also ask your doctor if adjusting the dose or switching medications might be helpful — but again, be sure to discuss the pros and cons before making such a decision.

Sources: The Mayo Clinic, NAMI, NIMH

Psychotherapy: An Overview

Mental Health, Mental Illness Treatments, Therapies

Psychotherapy is a general term for treating mental health problems by talking with a psychiatrist, psychologist or other mental health provider.

During psychotherapy, you learn about your condition and your moods, feelings, thoughts and behaviors. Psychotherapy helps you learn how to take control of your life and respond to challenging situations with healthy coping skills.

There are many types of psychotherapy, each with its own approach. The type of psychotherapy that’s right for you depends on your individual situation. Psychotherapy is also known as talk therapy, counseling, psychosocial therapy or, simply, therapy.

Why it’s done

Psychotherapy can be helpful in treating most mental health problems, including:

• Anxiety disorders, such as obsessive-compulsive disorder (OCD), phobias, panic disorder or post-traumatic stress disorder (PTSD)

• Mood disorders, such as depression or bipolar disorder

• Addictions, such as alcoholism, drug dependence or compulsive gambling

• Eating disorders, such as anorexia or bulimia

• Personality disorders, such as borderline personality disorder or dependent personality disorder

• Schizophrenia or other disorders that cause detachment from reality (psychotic disorders)

Not everyone who benefits from psychotherapy is diagnosed with a mental illness. Psychotherapy can help with a number of life’s stresses and conflicts that can affect anyone. For example, it may help you:

• Resolve conflicts with your partner or someone else in your life

• Relieve anxiety or stress due to work or other situations

• Cope with major life changes, such as divorce, the death of a loved one or the loss of a job

• Learn to manage unhealthy reactions, such as road rage or passive-aggressive behavior

• Come to terms with an ongoing or serious physical health problem, such as diabetes, cancer or long-term (chronic) pain

• Recover from physical or sexual abuse or witnessing violence

• Cope with sexual problems, whether they’re due to a physical or psychological cause

• Sleep better, if you have trouble getting to sleep or staying asleep (insomnia)

In some cases, psychotherapy can be as effective as medications, such as antidepressants. However, depending on your specific situation, psychotherapy alone may not be enough to ease the symptoms of a mental health condition. You may also need medications or other treatments.

Risks

Generally, there’s little risk in having psychotherapy. But because it can explore painful feelings and experiences, you may feel emotionally uncomfortable at times. However, any risks are minimized by working with a skilled therapist who can match the type and intensity of therapy with your needs.

The coping skills that you learn can help you manage and conquer negative feelings and fears.

How you prepare

Here’s how to get started:

• Find a therapist. Get a referral from a doctor, health insurance plan, friend or other trusted source. Many employers offer counseling services or referrals through employee assistance programs (EAPs). Or you can find a therapist on your own, for instance, by looking for a professional association on the Internet.

• Understand the costs. If you have health insurance, find out what coverage it offers for psychotherapy. Some health plans cover only a certain number of psychotherapy sessions a year. Also, talk to your therapist about fees and payment options.

• Review your concerns. Before your first appointment, think about what issues you’d like to work on. While you also can sort this out with your therapist, having some sense in advance may provide a good starting point.

Check qualifications

Before seeing a psychotherapist, check his or her background, education, certification, and licensing. Psychotherapist is a general term rather than a job title or indication of education, training or licensure.

Trained psychotherapists can have a number of different job titles, depending on their education and role. Most have a master’s or doctoral degree with specific training in psychological counseling. Medical doctors who specialize in mental health (psychiatrists) can prescribe medications as well as provide psychotherapy.

Examples of psychotherapists include psychiatrists, psychologists, licensed professional counselors, licensed social workers, licensed marriage and family therapists, psychiatric nurses, or other licensed professionals with mental health training.

Make sure that the therapist you choose meets state certification and licensing requirements for his or her particular discipline. The key is to find a skilled therapist who can match the type and intensity of therapy with your needs.

What you can expect

Your first therapy session:

At the first psychotherapy session, the therapist typically gathers information about you and your needs. You may be asked to fill out forms about your current and past physical and emotional health. It might take a few sessions for your therapist to fully understand your situation and concerns and to determine the best approach or course of action.

The first session is also an opportunity for you to interview your therapist to see if his or her approach and personality are going to work for you. Make sure you understand:

• What type of therapy will be used

• The goals of your treatment

• The length of each session

• How many therapy sessions you may need

Don’t hesitate to ask questions anytime during your appointment. If you don’t feel comfortable with the first psychotherapist you see, try someone else. Having a good fit with your therapist is critical for psychotherapy to be effective.

Starting psychotherapy

You’ll likely meet in your therapist’s office or a clinic once a week or every other week for a session that lasts about 45 to 60 minutes. Psychotherapy, usually in a group session with a focus on safety and stabilization, also can take place in a hospital if you’ve been admitted for treatment.

Types of psychotherapy

There are a number of effective types of psychotherapy. Some work better than others in treating certain disorders and conditions. In many cases, therapists use a combination of techniques. Your therapist will consider your particular situation and preferences to determine which approach may be best for you.

Although many types of therapies exist, some psychotherapy techniques proven to be effective include:

• Cognitive behavioral therapy (CBT), which helps you identify unhealthy, negative beliefs and behaviors and replace them with healthy, positive ones

• Dialectical behavior therapy, a type of CBT that teaches behavioral skills to help you handle stress, manage your emotions and improve your relationships with others

• Acceptance and commitment therapy, which helps you become aware of and accept your thoughts and feelings and commit to making changes, increasing your ability to cope with and adjust to situations

• Psychodynamic and psychoanalysis therapies, which focus on increasing your awareness of unconscious thoughts and behaviors, developing new insights into your motivations, and resolving conflicts

• Interpersonal psychotherapy, which focuses on addressing problems with your current relationships with other people to improve your interpersonal skills — how you relate to others, such as family, friends and colleagues

• Supportive psychotherapy, which reinforces your ability to cope with stress and difficult situations

Psychotherapy is offered in different formats, including individual, couple, family or group therapy sessions, and it can be effective for all age groups.

During psychotherapy

For most types of psychotherapy, your therapist encourages you to talk about your thoughts and feelings and what’s troubling you. Don’t worry if you find it hard to open up about your feelings. Your therapist can help you gain more confidence and comfort as time goes on.

Because psychotherapy sometimes involves intense emotional discussions, you may find yourself crying, upset or even having an angry outburst during a session. Some people may feel physically exhausted after a session. Your therapist is there to help you cope with such feelings and emotions.

Your therapist may ask you to do “homework” — activities or practices that build on what you learn during your regular therapy sessions. Over time, discussing your concerns can help improve your mood, change the way you think and feel about yourself, and improve your ability to cope with problems.

Confidentiality

Except in rare and specific circumstances, conversations with your therapist are confidential. However, a therapist may break confidentiality if there is an immediate threat to safety (yours or someone else’s) or when required by state or federal law to report concerns to authorities. Your therapist can answer questions about confidentiality.

Length of psychotherapy

The number of psychotherapy sessions you need — as well as how frequently you need to see your therapist — depends on such factors as:

• Your particular mental illness or situation

• Severity of your symptoms

• How long you’ve had symptoms or have been dealing with your situation

• How quickly you make progress

• How much stress you’re experiencing

• How much your mental health concerns interfere with day-to-day life

• How much support you receive from family members and others

• Cost and insurance limitations

It may take only weeks to help you cope with a short-term situation. Or, treatment may last a year or longer if you have a long-term mental illness or other long-term concerns.

Results

Psychotherapy may not cure your condition or make an unpleasant situation go away. But it can give you the power to cope in a healthy way and to feel better about yourself and your life.

Getting the most out of psychotherapy

Take steps to get the most out of your therapy and help make it a success:

• Make sure you feel comfortable with your therapist. If you don’t, look for another therapist with whom you feel more at ease.

• Approach therapy as a partnership. Therapy is most effective when you’re an active participant and share in decision-making. Make sure you and your therapist agree about the major issues and how to tackle them. Together, you can set goals and measure progress over time.

• Be open and honest. Success depends on willingness to share your thoughts, feelings and experiences, and to consider new insights, ideas and ways of doing things. If you’re reluctant to talk about certain issues because of painful emotions, embarrassment or fears about your therapist’s reaction, let your therapist know.

• Stick to your treatment plan. If you feel down or lack motivation, it may be tempting to skip psychotherapy sessions. Doing so can disrupt your progress. Try to attend all sessions and to give some thought to what you want to discuss.

• Don’t expect instant results. Working on emotional issues can be painful and may require hard work. You may need several sessions before you begin to see improvement.

• Do your homework between sessions. If your therapist asks you to document your thoughts in a journal or do other activities outside of your therapy sessions, follow through. These homework assignments can help you apply what you’ve learned in the therapy sessions to your life.

• If psychotherapy isn’t helping, talk to your therapist. If you don’t feel that you’re benefiting from therapy after several sessions, talk to your therapist about it. You and your therapist may decide to make some changes or try a different approach that may be more effective.

Sources: The Mayo Clinic, NAMI, NIH, NIMH

Antidepressants and Alcohol

Depression, Medications, Mental Health, Side Effects

It’s best to avoid combining antidepressants and alcohol. It may worsen your symptoms, and it can be dangerous. If you mix antidepressants and alcohol:

• You may feel more depressed or anxious. Drinking can counteract the benefits of your antidepressant medication, making your symptoms more difficult to treat. Alcohol may seem to improve your mood in the short term, but its overall effect increases symptoms of depression and anxiety.

• Side effects may be worse if you also take another medication. Many medications can cause problems when taken with alcohol — including anti-anxiety medications, sleep medications and prescription pain medications. Side effects may worsen if you drink alcohol and take one of these drugs along with an antidepressant.

• You may be at risk of a dangerous reaction if you take MAOIs. When combined with certain types of alcoholic beverages and foods, antidepressants called monoamine oxidase inhibitors (MAOIs) can cause a dangerous spike in blood pressure. If you take an MAOI, be sure you know what’s safe to eat and drink, and which alcoholic beverages are likely to cause a reaction.

• Your thinking and alertness may be impaired. The combination of antidepressants and alcohol will affect your judgment, coordination, motor skills and reaction time more than alcohol alone. Some combinations may make you sleepy. This can impair your ability to drive or do other tasks that require focus and attention.

• You may become sedated or feel drowsy. A few antidepressants cause sedation and drowsiness, and so does alcohol. When taken together, the combined effect can be intensified.

Don’t stop taking an antidepressant or other medication just so that you can drink. Most antidepressants require taking a consistent, daily dose to maintain a constant level in your system and work as intended. Stopping and starting your medications can make your depression worse.

While it’s generally best not to drink at all if you’re depressed, ask your doctor. If you have depression:

• You may be at risk of alcohol abuse. People with depression are at increased risk of substance abuse and addiction. If you have trouble controlling your alcohol use, you may need treatment for alcohol dependence before your depression improves.

• You may have trouble sleeping. Some people who are depressed have trouble sleeping. Using alcohol to help you sleep may let you fall asleep quickly, but you tend to wake up more in the middle of the night.

If you’re concerned about your alcohol use, you may benefit from substance abuse counseling and treatment programs that can help you overcome your misuse of alcohol. Joining a support group or a 12-step program such as Alcoholics Anonymous may help.

If you’re at low risk of addiction to alcohol, it may be OK to have an occasional drink, depending on your particular situation, but talk with your doctor.

Also, tell your doctor about any other health conditions you might have and any other medications you take, including over-the-counter medications or supplements. Keeping your doctor informed is important because:

• Some liquid medications, such as cough syrups, can contain alcohol

• As you age, your body processes medication differently and levels of medication in your body may need to be adjusted

• Adding a new medication may change the level of another medication in your body and how it reacts to alcohol

Sources: The Mayo Clinic, NAMI, NIH, NIMH

Depression and the Gender Gap

Depression, Mental Health, Women

Women are nearly twice as likely as men to be diagnosed with depression. Depression can occur at any age.

Some mood changes and depressed feelings occur with normal hormonal changes. But hormonal changes alone don’t cause depression. Other biological factors, inherited traits, and personal life circumstances and experiences are associated with a higher risk of depression. Here’s what contributes to depression in women.

Puberty

Hormone changes during puberty may increase some girls’ risk of developing depression. However, temporary mood swings related to fluctuating hormones during puberty are normal — these changes alone don’t cause depression.

Puberty is often associated with other experiences that can play a role in depression, such as:

• Emerging sexuality and identity issues

• Conflicts with parents

• Increasing pressure to achieve in school, sports or other areas of life

After puberty, depression rates are higher in females than in males. Because girls typically reach puberty before boys do, they’re more likely to develop depression at an earlier age than boys are. There is evidence to suggest that this depression gender gap may continue throughout the lifespan.

Premenstrual problems

For most females with premenstrual syndrome (PMS), symptoms such as abdominal bloating, breast tenderness, headache, anxiety, irritability and experiencing the blues are minor and short-lived.

But a small number of females have severe and disabling symptoms that disrupt their studies, jobs, relationships or other areas of their lives. At that point, PMS may cross the line into premenstrual dysphoric disorder (PMDD) — a type of depression that generally requires treatment.

The exact interaction between depression and PMS remains unclear. It’s possible that cyclical changes in estrogen, progesterone and other hormones can disrupt the function of brain chemicals such as serotonin that control mood. Inherited traits, life experiences and other factors appear to play a role.

Pregnancy

Dramatic hormonal changes occur during pregnancy, and these can affect mood. Other issues also may increase the risk of developing depression during pregnancy or during attempts to become pregnant, such as:

• Lifestyle or work changes or other life stressors

• Relationship problems

• Previous episodes of depression, postpartum depression or PMDD

• Lack of social support

• Unintended or unwanted pregnancy

• Miscarriage

• Infertility

• Stopping use of antidepressant medications

Postpartum depression

Many new mothers find themselves sad, angry and irritable, and experience crying spells soon after giving birth. These feelings — sometimes called the baby blues — are normal and generally subside within a week or two. But more-serious or long-lasting depressed feelings may indicate postpartum depression, particularly if signs and symptoms include:

• Crying more often than usual

• Low self-esteem or feeling like you’re a bad mom

• Anxiety or feeling numb

• Trouble sleeping, even when your baby is sleeping

• Problems with daily functioning

• Inability to care for your baby

• Thoughts of harming your baby

• Thoughts of suicide

Postpartum depression is a serious medical condition requiring prompt treatment. It occurs in about 10 to 15 percent of women. It’s thought to be associated with:

• Major hormonal fluctuations that influence mood

• The responsibility of caring for a newborn

• Predisposition to mood and anxiety disorders

• Pregnancy and birth complications

• Breast-feeding problems

• Infant complications or special needs

• Poor social support

Perimenopause and menopause

Risk of depression may increase during the transition to menopause, a stage called perimenopause, when hormone levels may fluctuate erratically. Depression risk may also rise during early menopause or after menopause — both times when estrogen levels are significantly reduced.

Most women who experience bothersome menopausal symptoms don’t develop depression. But these factors may increase the risk:

• Interrupted or poor sleep

• Anxiety or a history of depression

• Stressful life events

• Weight gain or a higher body mass index (BMI)

• Menopause at a younger age

• Menopause caused by surgical removal of the ovaries

Life circumstances and culture

The higher rate of depression in women isn’t due to biology alone. Life circumstances and cultural stressors can play a role, too. Although these stressors also occur in men, it’s usually at a lower rate. Factors that may increase the risk of depression in women include:

• Unequal power and status. Women are much more likely than men to live in poverty, causing concerns such as uncertainty about the future and decreased access to community and health care resources. These issues can cause feelings of negativity, low self-esteem and lack of control over life.

• Work overload. Often women work outside the home and still handle home responsibilities. Many women deal with the challenges of single parenthood, such as working multiple jobs to make ends meet. Also, women may be caring for their children while also caring for sick or older family members.

• Sexual or physical abuse. Women who were emotionally, physically or sexually abused as children or adults are more likely to experience depression at some point in their lives than those who weren’t abused. Women are more likely than men to experience sexual abuse.

Other conditions that occur with depression

Women with depression often have other mental health conditions that need treatment as well, such as:

• Anxiety. Anxiety commonly occurs along with depression in women.

• Eating disorders. There’s a strong link between depression in women and eating disorders such as anorexia and bulimia.

• Drug or alcohol misuse. Some women with depression also have some form of unhealthy substance use or dependence. Substance misuse can worsen depression and make it harder to treat.

Recognizing depression

Although depression might seem overwhelming, there’s effective treatment. Even severe depression often can be successfully treated. Seek help if you have any signs and symptoms of depression, such as:

• Ongoing feelings of sadness, guilt or hopelessness

• Loss of interest in things you once enjoyed

• Significant changes in your sleep pattern, such as trouble falling or staying asleep or sleeping too much

• Fatigue or unexplained pain or other physical symptoms without an apparent cause

• Problems concentrating or remembering things

• Changes in appetite leading to significant weight loss or weight gain

• Physical aches and pains

• Feeling as though life isn’t worth living, or having thoughts of suicide

Antidepressant Withdrawal: Is It Real?

Addiction, Medications, Mental Health, Side Effects

Antidepressant withdrawal is possible if you abruptly stop taking an antidepressant, particularly if you’ve been taking it longer than four to six weeks. Symptoms of antidepressant withdrawal are sometimes called antidepressant discontinuation syndrome and typically last for a few weeks. Certain antidepressants are more likely to cause withdrawal symptoms than others.

Quitting an antidepressant suddenly may cause symptoms within a day or two, such as:

• Anxiety

• Insomnia or vivid dreams

• Headaches

• Dizziness

• Tiredness

• Irritability

• Flu-like symptoms, including achy muscles and chills

• Nausea

• Electric shock sensations

• Return of depression symptoms

Having antidepressant withdrawal symptoms doesn’t mean you’re addicted to an antidepressant. Addiction represents harmful, long-term chemical changes in the brain. It’s characterized by intense cravings, the inability to control your use of a substance and negative consequences from that substance use. Antidepressants don’t cause these issues.

To minimize the risk of antidepressant withdrawal, talk with your doctor before you stop taking an antidepressant. Your doctor may recommend that you gradually reduce the dose of your antidepressant for several weeks or more to allow your body to adapt to the absence of the medication.

In some cases, your doctor may prescribe another antidepressant or another type of medication on a short-term basis to help ease symptoms as your body adjusts. If you’re switching from one type of antidepressant to another, your doctor may have you start taking the new one before you completely stop taking the original medication.

It’s sometimes difficult to tell the difference between withdrawal symptoms and returning depression symptoms after you stop taking an antidepressant. Keep your doctor informed of your signs and symptoms. If your depression symptoms return, your doctor may recommend that you start taking an antidepressant again or that you get other treatment.

Sources: The Mayo Clinic, NAMI, NIMH

Schizoid Personality Disorder: Symptoms

Diagnosis Symptoms, Mental Health

Schizoid personality disorder is an uncommon condition in which people avoid social activities and consistently shy away from interaction with others. They also have a limited range of emotional expression.

If you have schizoid personality disorder, you may be seen as a loner or dismissive of others, and you may lack the desire or skill to form close personal relationships. Because you don’t tend to show emotion, you may appear as though you don’t care about others or what’s going on around you.

The cause of schizoid personality disorder is unknown. Talk therapy, and in some cases medications, can help.

Symptoms

If you have schizoid personality disorder, it’s likely that you:

• Prefer being alone and choose to do activities alone

• Don’t want or enjoy close relationships

• Feel little if any desire for sexual relationships

• Feel like you can’t experience pleasure

• Have difficulty expressing emotions and reacting appropriately to situations

• May seem humorless, indifferent or emotionally cold to others

• May appear to lack motivation and goals

• Don’t react to praise or critical remarks from others

Schizoid personality disorder usually begins by early adulthood, though some features may be noticeable during childhood. These features may cause you to have trouble functioning well in school, a job, socially or in other areas of life. However, you may do reasonably well in your job if you mostly work alone.

Schizotypal personality disorder and schizophrenia

Although a different disorder, schizoid personality disorder can have some similar symptoms to schizotypal personality disorder and schizophrenia, such as a severely limited ability to make social connections and a lack of emotional expression. People with these disorders may be viewed as odd or eccentric.

Even though the names may sound similar, unlike schizotypal personality disorder and schizophrenia, people with schizoid personality disorder:

• Are in touch with reality, so they’re unlikely to experience paranoia or hallucinations

• Make sense when they speak (although the tone may not be lively), so they don’t have conversational patterns that are strange and hard to follow

Causes

Personality is the combination of thoughts, emotions and behaviors that makes you unique. It’s the way you view, understand and relate to the outside world, as well as how you see yourself. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.

In normal development, children learn over time to accurately interpret social cues and respond appropriately. What causes the development of schizoid personality disorder is unknown, although a combination of genetic and environmental factors, particularly in early childhood, may play a role in developing the disorder.

Risk factors

Factors that increase your risk of developing schizoid personality disorder include:

• Having a parent or other relative who has schizoid personality disorder, schizotypal personality disorder or schizophrenia

• Having a parent who was cold, neglectful or unresponsive to emotional needs

Complications

People with schizoid personality disorder are at an increased risk of:

• Developing schizotypal personality disorder, schizophrenia or another delusional disorder

• Other personality disorders

• Major depression

• Anxiety disorders